35 - Past Performance Reference Sheets.docx
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- Attached to
- Military OneSource Program - Request for Proposal (RFP) 47QFCA23R0053 Federal contract opportunity
- Solicitation number
- 47QFCA23R0053
About this file
This document provides a past performance survey form template for references to evaluate a contractor's performance on a previous federal government contract. The template requests ratings and comments on technical quality, schedule, cost control, management, small business subcontracting, and regulatory compliance. References are asked to provide their name, organization, title, contact information, and signature. The related federal contract opportunity is a solicitation from the General Services Administration for the Military OneSource Program, with responses due on an unspecified date.
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Text version
PAST PERFORMANCE SURVEY FORM
ATTACHMENT 35
PAST PERFORMANCE REFERENCE SHEETS
(To be removed at time of award)
Your immediate attention is requested. Please return the completed survey form to the contractor you are completing this survey for, no later than (insert date).
You have been identified as a reference for ___________ (insert name of contractor). Using the rating table, please provide concise comments and ratings regarding your overall assessment of the contractor’s performance on the contract identified below. The contractor will be responsible for submitting your Past Performance Survey Form with its comprehensive proposal in response to the Government’s Request for Proposal (RFP). Please be aware that a rating without concise comments as to the basis for the rating may require the evaluators to contact you for the necessary information, and may delay the evaluation process.
RATING TABLE
1. Unsatisfactory – The contractor’s performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
2. Marginal – The contractor’s performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.
3. Satisfactory – The contractor’s performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.
4. Very Good – The contractor’s performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
5. Exceptional – The contractor’s performance meets contractual requirements and exceeds many to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
FEDSIM is a Client Support Center housed within GSA, FAS, AAS Page 1 of 2 Template Version 01-31-22
CONTRACT DESCRIPTION:
Contract Number:
Contract Type:
NAICS Code:
| Award Amount: |
| $ |
| Period of Performance: |
| From: [Month Day, Year] To: [Month Day, Year] |
| Services provided by the offeror: |
| [Provide a brief description] |
TECHNICAL/QUALITY OF SERVICE
Strengths:
Weaknesses:
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
SCHEDULE/TIMELINESS
Strengths:
Weaknesses:
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
COST CONTROL (DO NOT RATE IF THE CONTRACT/TASK ORDER WAS FIRM-FIXED-PRICE)
Strengths:
Weaknesses:
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
MANAGEMENT
Strengths:
Weaknesses:
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
SMALL BUSINESS SUBCONTRACTING
Strengths:
Weaknesses:
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
REGULATORY COMPLIANCE
Strengths:
Weaknesses:
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
CONTRACTORS OVERALL PERFORMANCE
Please rate the contractor’s overall performance under this contract.
| Rating (1, 2, 3, 4 or 5) |
| Choose an item. |
Additional Comments:
YOUR COOPERATION IN COMPLETING THIS SURVEY IS GREATLY APPRECIATED.
Name of Reference:
Organization:
Title:
Telephone:
FAX:
Email:
| Signature: |
| Date: |
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